Ohio Medicaid for seniors and long-term care

Last verified: June 2026

$2,000

Asset limit (individual)

PASSPORT

Home waiver via AAAs

MyCare Ohio

Dual-eligibles, 29 counties

60 months

Asset transfer lookback

Ohio LTC Medicaid uses different rules than standard Ohio Medicaid — apply through your county CJFS

Long-term care Medicaid involves financial and functional eligibility rules that differ entirely from the ACA expansion program. Ohio Medicaid LTC has a $2,000 asset limit and requires a nursing-facility-level-of-care assessment. Apply through your county Job and Family Services (CJFS) office. For situation-specific guidance, consult a licensed elder law attorney.

Ohio has an estate recovery program for long-term care recipients

Ohio Medicaid can recover costs from the estates of deceased enrollees who received long-term care services, including nursing facility care and certain home and community-based waiver services. This applies after age 55 or after a period of institutional care. Estate recovery can affect what heirs inherit. Consult an elder law attorney if this affects your planning.

PASSPORT: Ohio's main home and community-based waiver

The PASSPORT waiver is Ohio's primary Home and Community-Based Services (HCBS) waiver for seniors and adults with disabilities who meet nursing facility level of care. Under Section 1915(c) of the Social Security Act, PASSPORT allows Ohio to provide services at home that would otherwise require institutional care. The program is administered through a network of Area Agencies on Aging (AAA) across Ohio's 88 counties.

PASSPORT has a waitlist in some areas. Applicants who qualify medically may wait weeks to months depending on county and available funding slots. Being on the PASSPORT waitlist does not guarantee enrollment — it depends on available capacity. Contact your local AAA for current wait times.

Services covered under PASSPORT include:

Personal care — help with bathing, dressing, grooming, and mobility
Homemaker services — light housekeeping, laundry, meal preparation
Home-delivered meals (Meals on Wheels, administered through AAA partners)
Adult day services
Respite care for family caregivers
Care coordination — a PASSPORT case manager coordinates all waiver services
Home modifications for accessibility (ramps, grab bars, widened doorways)
Transportation to medical appointments

MyCare Ohio: coordinated coverage for dual eligibles

MyCare Ohio is Ohio's integrated care program for people enrolled in both Medicare and Medicaid — called dual eligibles. It operates in 29 Ohio counties. MyCare Ohio coordinates medical care, behavioral health, and long-term services and supports through a single managed care plan, so members have one plan and one care coordinator managing both Medicare and Medicaid benefits.

Dual eligibles outside the 29 MyCare Ohio counties receive their Medicare and Medicaid benefits through separate channels — Medicare through traditional Medicare or a Medicare Advantage plan, and Ohio Medicaid through one of the five standard MCOs.

Enrollment in MyCare Ohio is voluntary in most counties. Contact ODM or your county CJFS office to ask whether MyCare Ohio is available in your county and whether it makes sense given your current providers.

Nursing facility coverage: eligibility and asset rules

Ohio Medicaid covers nursing facility care for enrollees who meet both a medical level-of-care standard and the financial eligibility rules. The level-of-care determination is made by ODM — applicants must require nursing-level care, meaning they cannot safely live at home or in assisted living without skilled nursing support.

Financial rules for nursing facility Medicaid are separate from the MAGI-based rules for standard adult coverage. An individual applicant for nursing facility Medicaid must have countable resources at or below $2,000. Countable resources include bank accounts, investments, and most personal property. Exempt resources include the primary home (while a spouse or dependent lives there), one vehicle, personal belongings, and a small burial fund.

Income also matters for nursing facility coverage. Most of a resident's income — Social Security, pension, retirement distributions — goes toward the cost of care as a "patient pay amount." Ohio Medicaid pays the facility the difference between what the resident can contribute and the facility's Medicaid rate.

Once in a nursing facility, an enrollee may retain up to $50 per month as a personal needs allowance; the rest of their income is applied to the cost of care.

Spousal protections: what the community spouse can keep

Federal spousal impoverishment rules under 42 U.S.C. § 1396r-5 protect the spouse who remains at home (the "community spouse") from having to give up all marital assets to get the nursing facility spouse onto Medicaid. Ohio applies these rules.

The community spouse can retain half of the couple's countable assets at the time of the Medicaid application, up to the federal maximum Community Spouse Resource Allowance (CSRA). For 2025, the federal maximum CSRA is $157,920. The minimum CSRA is $29,724. Assets above the applicable CSRA must be spent down before the nursing facility spouse qualifies.

The community spouse is also protected from having to contribute their income to the nursing facility spouse's care. A Monthly Maintenance Needs Allowance (MMNA) calculation ensures the community spouse retains enough income to cover their own living expenses.

Ohio's estate recovery program

Per the Ohio Department of Medicaid, Ohio recovers Medicaid costs from the estates of deceased recipients who were age 55 or older when they received nursing facility care, PASSPORT waiver services, or other long-term care services. Recovery may extend to liens on real property in certain situations. The home is generally protected while a surviving spouse, minor child, or disabled child lives there — but becomes subject to recovery after they vacate or pass away. An elder law attorney can help structure assets and plan around estate recovery legally.

Spousal impoverishment protections at a glance

Federal law (42 U.S.C. § 1396r-5) protects the community spouse when their partner enters a nursing facility. Ohio applies these protections through county CJFS eligibility determinations.

Protection	2025 amount	Notes
Community Spouse Resource Allowance (CSRA)	Up to ~$157,920	Federal maximum; Ohio uses the maximum allowable figure. Verify with county CJFS or an elder law attorney
Minimum Monthly Maintenance Needs Allowance (MMMNA)	Set annually by CMS	Community spouse retains sufficient income to cover living expenses; floor and cap update each January
Institutionalized spouse asset limit	$2,000	Primary home (while community spouse occupies), one vehicle, and personal belongings are typically exempt

Source: 42 U.S.C. § 1396r-5; Ohio Department of Medicaid long-term care rules. Verify current figures with your county CJFS office or a licensed Ohio elder law attorney.

What Ohio long-term care Medicaid covers

Nursing facility care (indefinite, once medical and financial criteria are met)
PASSPORT waiver — personal care, homemaker, adult day services, respite, and home health aide
MyCare Ohio — integrated physical, behavioral, and long-term care for Medicare-Medicaid dual-eligibles (29 counties)
CHOICES waiver — HCBS for adults age 60+ who can remain in the community
Ohio HOME Choice — transition support from nursing facility back to the community
Transportation to medical appointments
Assistive technology and home modifications (through HCBS waivers)

Ohio participates in Medicaid estate recovery

After an Ohio Medicaid recipient age 55 or older who received nursing facility or HCBS waiver services passes away, Ohio Medicaid may file a claim against the estate to recover costs. Recovery is deferred while a surviving spouse, minor child, or blind or disabled child is living. Hardship exemptions exist. Consult a licensed Ohio elder law attorney before making asset transfers or planning a home transfer. See the national estate recovery guide for broader context.